發(fā)布時間：2018-03-26 07:44

  本文選題：內(nèi)聽動脈　切入點(diǎn)：神經(jīng)內(nèi)鏡　出處：《聽力學(xué)及言語疾病雜志》2017年06期

【摘要】：目的在神經(jīng)內(nèi)鏡及手術(shù)顯微鏡下觀測內(nèi)聽動脈(internal auditory artery,IAA)的解剖特點(diǎn),探討其臨床應(yīng)用價值。方法在12具甲醛固定和3具新鮮成人尸頭標(biāo)本上,采用乙狀竇后入路行開顱手術(shù),在模擬手術(shù)條件下用各角度神經(jīng)內(nèi)鏡與顯微鏡觀測內(nèi)聽動脈的起源、分支、走行方向、毗鄰關(guān)系和常見變異。結(jié)果所有標(biāo)本均于雙側(cè)觀察到內(nèi)聽動脈(100%),其中單干17側(cè)(56.7%,17/30),雙干9側(cè)(30%,9/30),3干4側(cè)(13.3%,4/30);其起始部的管徑0.12~0.28mm,平均0.22±0.04mm;長度7.12~14.82mm,平均10.18±2.63mm。30側(cè)中4側(cè)內(nèi)聽動脈(13.3%,4/30)從基底動脈下段發(fā)出;26側(cè)(86.7%,26/30)起自小腦前下動脈,其中17側(cè)(65.4%,17/26)發(fā)起于小腦前下動脈袢頂附近,9側(cè)(34.6%,9/26)由突入內(nèi)耳道內(nèi)的小腦前下動脈發(fā)出。所有標(biāo)本的內(nèi)聽動脈發(fā)出后隨面神經(jīng)和前庭蝸神經(jīng)進(jìn)入內(nèi)聽道,22側(cè)(73.3%,22/30)位于神經(jīng)束前下,8側(cè)(26.7%,8/30)位于神經(jīng)束上方和后方,15例標(biāo)本(100%)IAA在內(nèi)聽道末端均恒定分為前庭動脈、前庭蝸動脈和耳蝸動脈;通過內(nèi)鏡才能看清神經(jīng)束腹側(cè)的血管。結(jié)論內(nèi)聽動脈多位于面聽神經(jīng)前下方,手術(shù)顯微鏡無法直接窺及,聯(lián)合應(yīng)用手術(shù)顯微鏡和神經(jīng)內(nèi)鏡,可觀測內(nèi)聽動脈顱內(nèi)段幾乎所有行程和毗鄰結(jié)構(gòu)。
[Abstract]:Objective to observe the anatomical characteristics of internal auditory artery under endoscope and operation microscope and to evaluate its clinical value. Methods the craniotomy was performed by retrosigmoid approach on 12 formaldehyde fixed and 3 fresh adult cadaveric head specimens. The origin, branch and direction of the internal auditory artery were observed by endoscopy and microscope under simulated surgical conditions. Results all specimens were observed on both sides of the internal auditory artery, including 17 sides of 17 sides with 56.7% 17 / 30, 9 sides of the double trunk 9 / 30 and 4 sides of the fourth side of the trunk, with a diameter of 0.120.28 mm, an average of 0.22 鹵0.04 mm, and a length of 7.12 鹵14.82 mm, with an average of 10.18 鹵10.18 鹵4 sides of the medial auditory artery 13.33% of the total. From the inferior part of the basilar artery, from the inferior cerebellar artery to the anterior inferior cerebellar artery, Of these, 17 (65. 4 / 26) were initiated in 9 sides near the top of the loop of the anterior inferior cerebellar artery, and 9 / 26) from the anterior inferior cerebellar artery protruding into the internal auditory canal. In all the specimens, the internal auditory artery was sent out with the facial nerve and the cochlear nerve entering the internal auditory canal, and the 22 sides of the auditory canal were located at 73.33 / 2230). The end of the inner auditory canal was divided into the vestibular artery at the end of 100 IAA in 15 cases, located above and behind the nerve bundle, in 8 sides of the anterior and inferior bundles of the nerve tract, and 8 / 30 of the nerve bundles were located at the top and rear of the nerve bundle. The vestibulocochlear artery and cochlear artery; the ventral vessels of the nerve bundle can only be seen by endoscope. Conclusion the internal auditory artery is mostly located below the facial auditory nerve and can not be directly peeped under the surgical microscope. Intracranial segment of the internal auditory artery can be observed in almost all its journeys and adjacent structures.
【作者單位】： 武漢大學(xué)人民醫(yī)院神經(jīng)外科;華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院神經(jīng)外科;
【基金】：湖北省自然科學(xué)基金面上項(xiàng)目(2014CFB421)資助
【分類號】：R764
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本文編號：1667038